{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T19:45:00Z","timestamp":1775677500891,"version":"3.50.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness \u226410\u2009days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13\u2009months (July 2018\u2013August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A\/H1N1pdm09 being the predominant circulating strain during the study following a shift from A\/H3N2 from January\u2013February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329\u20130.970)], <jats:italic>p<\/jats:italic>\u00a0=\u20090.038) and of dyspnea (0.544 (0.341\u20130.868)], <jats:italic>p<\/jats:italic>\u00a0=\u20090.011) were associated with increased risk of influenza positivity. Overall, 184\/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU\/HDU) (13.2% were influenza positive) and 26\/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU\/HDU admission or death).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU\/HDU admission in this population.<\/jats:p>\n                <jats:p>Study registration, NMRR ID: NMRR-17-889-35,174.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06360-9","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T07:02:57Z","timestamp":1625468577000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: a multicenter, active surveillance study"],"prefix":"10.1186","volume":"21","author":[{"given":"Yong Kek","family":"Pang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Izuanuddin","family":"Ismail","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoke Fun","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelina","family":"Cheong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoong Min","family":"Chong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paras","family":"Doshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne Zhi Han","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Khor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilian Phei Lian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chee Loon","family":"Leong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisya Natasya","family":"Musa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kee Sing","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mau Ern","family":"Poh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Ching","family":"Sam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiunn Liang","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohd Arif Mohd","family":"Zim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Frieda","family":"Taurel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"6360_CR1","first-page":"461","volume":"87","author":"World Health Organization","year":"2012","unstructured":"World Health Organization. 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The study was conducted in accordance with Good Clinical Practice and Good Epidemiological Practice guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AC, JK and A-FT are employees of Sanofi Pasteur and may hold shares and\/or stock options in the company. AII, YFC, YMC, PD, JZHL, LPLW, CLL, ANM, KSN, MEP, JLT, and MAMZ have no conflicts to disclose. YKP received grant support from Sanofi Pasteur for the conduct of this study, and outside the submitted work, has previously received an honorarium to chair a webinar on behalf of Sanofi Pasteur. I-CS has received grant support from Sanofi Pasteur for the conduct of other studies and received honoraria to give talks.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"644"}}